Medicaid Unwinding in Maine: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Maine are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is being called the unwinding of Medicaid, and some people will lose coverage during this process.
During the PHE, Medicaid renewals were automatic, and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) stopped nationwide on March 31, 2023.
The Maine Department of Health and Human Services (DHHS) oversees the state’s Medicaid program, known as MaineCare, and the Children’s Health Insurance Program (CHIP), known as Cub Care. DHHS has restarted eligibility reviews and needs you to confirm or update your contact information. If they can’t reach you, or if you’re no longer eligible for Medicaid, you could lose coverage as early as June 1, 2023.
If you lose Medicaid coverage during the unwinding, you may qualify for a low-cost, alternative health insurance option, such as an Affordable Care Act marketplace plan.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. The PHE was renewed a dozen times between January 2020 and February 2023.
People who were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) during the COVID PHE were able to keep their insurance without renewing, because states were required to provide continuous coverage during the PHE.
But the PHE ended on May 11, 2023. This marks the end of most COVID provisions, including automatic Medicaid renewals, which stopped nationwide in March. This process — called the unwinding — is underway and could cause 5 million to 14 million enrollees nationwide to lose Medicaid coverage.
Prescription Savings Are Just the Beginning
See what other benefits you qualify for—from cashback cards to cheaper insurance.
Why is Medicaid changing nationwide?
Now that the PHE has ended, COVID-19 remains a public health priority — but not an emergency. As part of this change, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid.
The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories.
Here’s what you need to know about Medicaid changes in Maine, and what to do if you lose your insurance coverage.
What’s happening with Medicaid renewal in Maine?
The Maine Department of Health and Human Services (DHHS) is responsible for overseeing the state’s Medicaid program — which is called MaineCare — and Cub Care, the state’s Children’s Health Insurance Program (CHIP). The DHHS has an unwinding plan that outlines how the state plans to conduct eligibility reviews for current enrollees.
In April 2023, Maine resumed eligibility reviews for more than 400,000 enrollees in MaineCare and Cub Care. This is called the redetermination process. Anyone who no longer qualifies could be disenrolled as early as June 1, 2023. In fact, state officials estimate that 65,000 to 90,000 people in Maine could lose Medicaid or CHIP coverage.
The DHHS has launched an online portal called My Maine Connection. The portal makes it easier for MaineCare members to update their information, renew or apply for benefits, submit verifications, and more. Members can also enroll in text message and email alerts to receive information about upcoming renewals.
Read more like this
Explore these related articles, suggested for readers like you.
It’s important for you to confirm or update your household’s contact information with the DHHS. You can do this by:
Logging in to your account on the My Maine Connection portal
Calling the DHHS Office for Family Independence at 1-855-797-4357
What to expect during the renewal process
Under the unwinding plan, MaineCare renewal forms will be sent to enrollees on the 21st of the month before they are due. The form will come in an envelope with a blue stripe on it, to alert you that you need to renew. For example, if your renewal is due August 31, 2023, DHHS will send you a renewal form on July 21, 2023. The renewal forms will also be available via your My Maine Connection account, under “Renew Benefits,” when it’s time for you to submit information.
The DHHS will send out three mailings to enrollees regarding their renewal:
Renewal reminder notice: This will be sent in the quarter before the scheduled renewal. If your cell phone number or email address is on file, you will also receive the reminder via text or email.
Renewal form: This paper renewal form will be mailed in a blue-striped envelope at least 30 days before your renewal date. If you have signed up for text message or email alerts, you will also get a text or email notification about your renewal.
Notice of decision: This notice will let you know if your coverage will continue or not. MaineCare enrollees who do not qualify for renewal will be notified at least 15 days before courage ends. If you lose MaineCare coverage, DHHS will transfer your application to CoverME.org, Maine’s Affordable Care Act insurance marketplace.
If you fail to return your completed renewal packet by the deadline, you will have 90 days after your coverage ends to submit your information for reconsideration without having to reapply. You won’t have a coverage gap if you are eventually renewed.
If you need to reach MaineCare by phone, call the DHHS Office for Family Independence at 1-855-797-4357.
Tribal health and Medicaid unwinding
State liaisons are reaching out to the more than 1 million Medicaid and CHIP members nationwide who belong to or are affiliated with Native American tribes. This process includes DHHS collaborations with the four federally recognized tribes in Maine. The National Indian Health Board estimates that as many as 236,000 American Indians and Alaska Natives (AIs/ANs) could lose coverage during the unwinding process, including people in Maine.
What should I do if I lose my Medicaid coverage in Maine?
In order to receive Medicaid in Maine, you must meet all of the following criteria:
You must be a Maine resident.
You must be a U.S. citizen, permanent resident, or legal resident.
You must need assistance with access to healthcare or insurance coverage.
Your annual household income before taxes are withheld must be below the limit for your household size.
In Maine, you may also qualify for reasons other than or in addition to income, including if you are:
Pregnant
A child or teenager
Responsible for the care of a child who is 18 years old or younger
Blind
65 years old or older (and meet certain criteria)
A person with a disability, or you have a person in your household who has a qualifying disability
A former foster child
In need of nursing home care
Age 19 and older with family planning needs
In need of treatment for breast or cervical cancer (and have been screened or are still undergoing treatment)
If you no longer qualify or DHHS can’t reach you, you won’t be able to use your benefits anymore, which could leave you temporarily uninsured.
If you lose your coverage but believe you still qualify, you can reapply for Medicaid. You may be uninsured for a while until you’re approved for coverage again.
If you choose not to reapply for Medicaid coverage, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to enroll in an alternative health insurance plan, such as:
Affordable Care Act (ACA) marketplace: You may be able to enroll in an ACA health plan on CoverME.gov, which is the state’s ACA marketplace. You could find a plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan through CoverME.gov during the unwinding special enrollment period from March 31, 2023, to July 31, 2024.
Employer plan: If you have a job, you may be able to get employer-sponsored health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, such as job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Maine Medicaid resources
Here are some resources that can help you can learn more about Medicaid in Maine and upcoming changes related to the end of the PHE:
Maine Medicaid office: The Maine Department of Health and Human Services (DHHS) oversees and administers the state’s Medicaid program, MaineCare, and Cub Care, its CHIP program.
Maine Medicaid self-service portal: You can visit the My Maine Connection portal and access your account online 24/7 to confirm or update your contact information.
Maine Medicaid redetermination: Read more about Maine’s unwinding plan.
Maine Medicaid office phone assistance: You can call the DHHS Office for Family Independence at 1-855-797-4357.
Maine Medicaid FAQs: Find the answers to frequently asked questions.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023, in advance of the COVID-19 public health emergency’s conclusion on May 11, 2023.
The Maine Department of Health and Human Services (DHHS) oversees MaineCare, which is Maine’s Medicaid program, and Cub Care, the state’s CHIP program. DHHS will spend a year reviewing eligibility for more than 400,000 MaineCare and Cub Care enrollees. It’s important to provide DHHS with your current contact information to ensure the agency can reach you when it’s time to renew. Your renewal form will be mailed in an envelope with a blue stripe. Complete the renewal information by the deadline.
If you or your children no longer qualify for MaineCare or Cub Care, your application will be sent to CoverME.gov, Maine’s Affordable Care Act health insurance marketplace.
Why trust our experts?
References
Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
Andrews, C. (2023). Maine DHHS facing call wait times up to four hours long as federal benefits end. Maine Public.
Benefits.gov. (n.d.). Maine MaineCare.
Centers for Medicare & Medicaid Services. (2023). Temporary special enrollment period (SEP) for consumers losing Medicaid or the Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid continuous enrollment condition – Frequently asked questions (FAQ).
CoverMe.gov. (n.d.). MaineCare and Cub Care. State of Maine Department of Health and Human Services.
Department of Health and Human Services. (2022). Department of Health and Human Services’ (the Department) Tribal Collaboration Policy.
Medicaid.gov. (n.d.). Indian health & Medicaid.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
State of Maine Department of Health and Human Services. (n.d.). Health care assistance.
State of Maine Department of Health and Human Services. (n.d.). Unwinding plan for the end of Medicaid continuous coverage requirement and resumption of normal MaineCare eligibility operations.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
Tribal Health Reform Resource Center. (n.d.). Medicaid unwinding.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
Wright, P. (2023). Maine prepares for lapse of pandemic-era Medicaid eligibility safety net. Maine Public.
